Causes of misdiagnosis of chronic obstructive pulmonary disease: A systematic scoping review - 26/07/17

Doi : 10.1016/j.rmed.2017.05.015

Stine Hangaard ^a,^⁎ , Tina Helle ^b , Carl Nielsen ^c , Ole K. Hejlesen ^a
^a Aalborg University, Department of Health Science and Technology, Medical Informatics Group, Fredrik Bajers Vej 7C, 9220 Aalborg Ø, Denmark
^b University College of Northern Denmark, Department of Research and Development, Selma Lagerløfs Vej 2, 9220 Aalborg Ø, Denmark
^c Aalborg University Hospital, Department of Respiratory Diseases, Medicinerhuset, Mølleparkvej 4, 9000 Aalborg, Denmark

^∗Corresponding author. Fredrik Bajers Vej 7C, 9220 Aalbog Ø, Denmark.Fredrik Bajers Vej 7CAalbog Ø9220Denmark

Abstract

Background

Chronic obstructive pulmonary disease (COPD) has serious implications at both the individual and the societal level. It is crucial that COPD is diagnosed correctly to ensure provision of the right treatment. However, the current diagnostic procedures may lead to misdiagnosis.

Aim

The aim of this scoping review was to disseminate knowledge about potential causes of misdiagnosis of COPD.

Methods

A systematic, comprehensive search was performed in PubMed, Embase and Cinahl.

Results

A thorough review produced a sample of 73 articles. The synthesis revealed five potential causes of misdiagnosis of COPD, including: the threshold for defining COPD (n = 36), errors made in primary care (n = 15), errors linked to the spirometry test (n = 13), differential diagnoses (n = 10), and patient-related factors (n = 8).

Conclusions

The causes of misdiagnosis of COPD are attributable mainly to spirometry and to the healthcare professional performing the diagnostic assessment. With a view to limiting misdiagnosis of COPD, future research should help clarify strategies for alternative objective tests for determining if a patient has COPD and explore how to better support primary care in the diagnosing of COPD.

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Highlights

•	The study revealed five potential causes of misdiagnosis of COPD.
•	The causes of misdiagnosis of COPD are attributable mainly to spirometry.
•	Misdiagnosis of COPD often occurs due to errors made in primary care.

El texto completo de este artículo está disponible en PDF.

Keywords : Obstructive lung disease, Diagnostic error, Misdiagnoses, Spirometry, Primary care, Comorbidity

Abbreviations : COPD, FEV1, FVC, GOLD, LLN